Individual
DR. ADELE M. ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2900 FRANK SCOTT PKWY W, SUITE 980, BELLEVILLE, IL 62223-5000
(618) 234-9200
(618) 234-3940
Mailing address
2900 FRANK SCOTT PKWY W STE 980, BELLEVILLE, IL 62223-5000
(618) 234-9200
(618) 234-3940
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036069016
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036069016
—
IL
Enumeration date
09/21/2006
Last updated
05/24/2021
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